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Sotatercept Rescue Therapy for Acute Right Heart Failure in HIV-Associated PAH
Yaosi Li1, Daniel Grund1, Nils Kremer2,3
1Department of Infectious Diseases Respiratory Medicine and Critical Care, Charité-Universitätsmedizin Berlin Berlin Germany.
Pulmonary Circulation
|July 28, 2026
Summary
Sotatercept shows promise in treating acute decompensated pulmonary arterial hypertension (PAH) in HIV patients. This novel therapy rapidly improved right ventricular function and overall hemodynamics in a sepsis-triggered case.
Area of Science:
- Cardiology
- Pulmonology
- Infectious Diseases
Background:
- Pulmonary arterial hypertension (PAH) is a severe complication in patients with HIV, often excluded from clinical trials.
- Current treatments for HIV-associated PAH target specific pathways but have limitations.
Purpose of the Study:
- To report a case of acute decompensated HIV-associated PAH.
- To evaluate the potential of sotatercept as rescue therapy in this context.
Main Methods:
- A 58-year-old male with HIV-PAH and sepsis-induced acute right ventricular failure was treated.
- Guideline-directed therapies were escalated, followed by the initiation of sotatercept.
Main Results:
- Sotatercept initiation led to rapid improvement within 24 hours.
- Key improvements included enhanced echocardiographic RV function, decreased NT-proBNP, and recovery of renal function.
- The patient was successfully weaned from catecholamines and prostacyclin.
Conclusions:
- Sotatercept may serve as a potential rescue therapy for acute decompensated HIV-PAH.
- Further randomized controlled studies are needed to confirm efficacy in this high-risk population.
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